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Health Informatics New Zealand - www.hinz.org.nz




                                    Primary Health Care
                                    Strategy Information
                                    Environment

                                    Andrew Holmes and Vicki
                                    Mclaughlin
                                    Ministry of Health




An information environment to support
the Primary Health Care Strategy



Ministry of Health, with sector involvement has the
opportunity to submit a business case to Capital Committee
which needs to draw from a development pathway for PHC
information
Over 2006 we are facilitating the development of a Key
Directions document that Business Cases can come from.




                                                              1
Health Informatics New Zealand - www.hinz.org.nz




Scope
                                                      Information Purpose
                                                          Health Provision
               Health Provision



         Primary Health Organisations




            District Health Boards



                 Ministry of
                   Health


                   Minister
                                                          Accountability




Scope
Information environment required to support:

Provision of enhanced care
           system
           populations
           individuals

Accountability
          financial (Capitation Based Funding)
          performance
          political




                                                                             2
Health Informatics New Zealand - www.hinz.org.nz




Ministry’s view (A view from one mountain)
Provision of enhanced care

          Simple, highly cost effective interventions,
      for common, uncomplicated long term conditions,
               are not happening dependably




Ministry’s view (A view from one mountain)
      Accountability
                Area of control internal to the                     Area of influence external to the
                        organisation                                          organisation


                                                       Immediate      Intermediate      Final Outcomes
            Inputs
                            Activities       Outputs    Outcomes       Outcomes             Societal
          (Resources)
                                                         (Direct)       (Indirect)



                                                                         External factors
              HEALTH CARE EFFICIENCY                        HEALTH CARE EFFECTIVENESS



                                                       Treasury Board of Canada Results-based Logic Model (2001




                                                                                                                  3
Health Informatics New Zealand - www.hinz.org.nz




          Population Health Capability Framework


  End     Intermediate        Immediate                  Outputs                  Health                 Population                                     Individual
Outcome     Outcomes          Outcomes                                         Interventions             Health Risk                                    Health Risk
                                                                                                           Profile                                        Profile
                                                                                 (E.g. Screening,       (E.g. Demographic      (E.g. age, sex, weight, ethnicity, key diagnoses)
                                                                                 diet, medication,      profile, cause of
                                                                                 healthy schools)       death, life




                                                                                                                                     1


                                                                                                                                                    2


                                                                                                                                                                  3


                                                                                                                                                                                4


                                                                                                                                                                                             5
                                                                                                        expectancy & key




                                                                                                                                    file


                                                                                                                                               file


                                                                                                                                                             file


                                                                                                                                                                           file


                                                                                                                                                                                        file
                                                                                                        diagnoses)




                                                                                                                                Pro


                                                                                                                                           Pro


                                                                                                                                                         Pro


                                                                                                                                                                       Pro


                                                                                                                                                                                    Pro
                                                          i.    xxxx               Intervention a              Risk a



                                                          ii.   xxxx               Intervention b              Risk b

                                 a. xxxx

                                                          iii. xxxx                Intervention c              Risk c



             1 – xxxx                                     iv. xxxx                 Intervention d              Risk d


                                                          i.    xxxx


                                 b. xxxx                  ii.   xxxx                                                                                        =         Alerts

  AAA
                                                          iii. xxxx


                                 a. xxxx


             2 – xxx
                                                                                   Health Provider Team equipped with population health capability



                           Decision                                                     Action                                         Information




               The two streams

                                               Key Directions                                 FoundationProjects
                                                                                                   Foundation Projects
                                                                                             [Not covered by this project charter]

                                                   [Covered by this                        PHO            Service
                                                                                                           PHO           Capitation
                                                    project charter]                    Performance      Monitoring
                                                                                                         Utilisation    Based Funding


                                                                                         Strategic       Strategic        Strategic
                                                  Strategic Analysis
                                                                                         Analysis        Analysis         Analysis

                         March 06                                        Combined Strategic Analysis



                                                                                         Options          Options           Options
                                                                                         Analysis         Analysis          Analysis

                                                    Key Directions
                                                                                         Business        Business         Business
                                                                                          Case            Case             Case
                         August 06
                                                                                                      Business Case

                                                Funding identification
                                                Defining what projects
                                                 require new funding
                                       Options Analysis - Project Specific




                                                       Draft
                                           Business Cases - Project Specific
                         August 07          Final Combined Business Case




                                                                                                                                                                                                 4
Health Informatics New Zealand - www.hinz.org.nz




Overview
We are currently developing the project charter with sector
involvement (the kick-off workshop was on the 25th Dec)

The deliverables are:

A Key Directions for Primary Health Care Information
publication; to provide an overarching information direction
and development path to support the achievement of the
Primary Health Care Strategy vision that is informed by the
Health Information Strategy for New Zealand.

A robust business case for Information Systems to
support the release of capital funding.

The implementation and change plan; including
governance, approach and other mechanisms to support
implementation.




Process


The key dates are:

  April 2006 – Strategic analysis submission
  October 2006 – Key Directions publication
  August 2007 - Business case submission

The process and documentation must meet the requirements
of the ‘Business Case Guidelines for Investment in
Information Technology’




                                                               5
Health Informatics New Zealand - www.hinz.org.nz




  Connections

   Primary Health Care
      Strategy 2001
                                          Health Information
                                         Strategy for NZ 2005

                              Action Zone 7: Chronic      Action Zone 10:
                                care and disease       Primary & community
                                   management             care collection



        Key Directions: Primary Health Care
         Strategy Information Environment

PHO Performance   Diabetes/
  Framework         CVD




                                           Business Case for the:
                                           Primary Health Care
                                           Strategy Information
                                           Environment




                                                                             6

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Primary Health Care Strategy Information Environment

  • 1. Health Informatics New Zealand - www.hinz.org.nz Primary Health Care Strategy Information Environment Andrew Holmes and Vicki Mclaughlin Ministry of Health An information environment to support the Primary Health Care Strategy Ministry of Health, with sector involvement has the opportunity to submit a business case to Capital Committee which needs to draw from a development pathway for PHC information Over 2006 we are facilitating the development of a Key Directions document that Business Cases can come from. 1
  • 2. Health Informatics New Zealand - www.hinz.org.nz Scope Information Purpose Health Provision Health Provision Primary Health Organisations District Health Boards Ministry of Health Minister Accountability Scope Information environment required to support: Provision of enhanced care system populations individuals Accountability financial (Capitation Based Funding) performance political 2
  • 3. Health Informatics New Zealand - www.hinz.org.nz Ministry’s view (A view from one mountain) Provision of enhanced care Simple, highly cost effective interventions, for common, uncomplicated long term conditions, are not happening dependably Ministry’s view (A view from one mountain) Accountability Area of control internal to the Area of influence external to the organisation organisation Immediate Intermediate Final Outcomes Inputs Activities Outputs Outcomes Outcomes Societal (Resources) (Direct) (Indirect) External factors HEALTH CARE EFFICIENCY HEALTH CARE EFFECTIVENESS Treasury Board of Canada Results-based Logic Model (2001 3
  • 4. Health Informatics New Zealand - www.hinz.org.nz Population Health Capability Framework End Intermediate Immediate Outputs Health Population Individual Outcome Outcomes Outcomes Interventions Health Risk Health Risk Profile Profile (E.g. Screening, (E.g. Demographic (E.g. age, sex, weight, ethnicity, key diagnoses) diet, medication, profile, cause of healthy schools) death, life 1 2 3 4 5 expectancy & key file file file file file diagnoses) Pro Pro Pro Pro Pro i. xxxx Intervention a Risk a ii. xxxx Intervention b Risk b a. xxxx iii. xxxx Intervention c Risk c 1 – xxxx iv. xxxx Intervention d Risk d i. xxxx b. xxxx ii. xxxx = Alerts AAA iii. xxxx a. xxxx 2 – xxx Health Provider Team equipped with population health capability Decision Action Information The two streams Key Directions FoundationProjects Foundation Projects [Not covered by this project charter] [Covered by this PHO Service PHO Capitation project charter] Performance Monitoring Utilisation Based Funding Strategic Strategic Strategic Strategic Analysis Analysis Analysis Analysis March 06 Combined Strategic Analysis Options Options Options Analysis Analysis Analysis Key Directions Business Business Business Case Case Case August 06 Business Case Funding identification Defining what projects require new funding Options Analysis - Project Specific Draft Business Cases - Project Specific August 07 Final Combined Business Case 4
  • 5. Health Informatics New Zealand - www.hinz.org.nz Overview We are currently developing the project charter with sector involvement (the kick-off workshop was on the 25th Dec) The deliverables are: A Key Directions for Primary Health Care Information publication; to provide an overarching information direction and development path to support the achievement of the Primary Health Care Strategy vision that is informed by the Health Information Strategy for New Zealand. A robust business case for Information Systems to support the release of capital funding. The implementation and change plan; including governance, approach and other mechanisms to support implementation. Process The key dates are: April 2006 – Strategic analysis submission October 2006 – Key Directions publication August 2007 - Business case submission The process and documentation must meet the requirements of the ‘Business Case Guidelines for Investment in Information Technology’ 5
  • 6. Health Informatics New Zealand - www.hinz.org.nz Connections Primary Health Care Strategy 2001 Health Information Strategy for NZ 2005 Action Zone 7: Chronic Action Zone 10: care and disease Primary & community management care collection Key Directions: Primary Health Care Strategy Information Environment PHO Performance Diabetes/ Framework CVD Business Case for the: Primary Health Care Strategy Information Environment 6